Traumatic Axillary Artery Repair

Abstract

Introduction: Only 15%–20% of the arterial injuries of the upper limbs are due traumatic axillary artery injury. Out of all ninety four percent are due to penetrating wounds, while the remaining 6% are caused by blunt traumas. Four cases with traumatic axillary artery injury are reported here. Materials and Methods: Four patients diagnosed with traumatic axillary artery injury underwent vascular repair presented between October 2019 and September 2020 are included in this study. Results: Fifty percent of patients presented with blunt trauma, whereas 50% with penetrating injury. Only one patient had associated bone injury. Hundred per cent of the patients had absent peripheral pulsation, while 50% of patients presented with warm upper extremity and normal capillary refill time. Seventy-five percent of patients involved had trauma to 1st part of axillary artery, whereas one patient suffered trauma to 2nd part. Two incisions, i.e. supraclavicular and infraclavicular incisions were taken to take proximal control of subclavian artery in two patients with trauma to 1st part of axillary artery. Only one patient underwent vascular repair with reverse saphenous vein graft, rest all patients underwent end-to-end axillary artery repair. Twenty-five percent of patients had associated brachial plexus injury and bone injury, respectively, which were taken care off along arterial repair. Hundred percent of the patients had good vascular outcome postoperatively. Conclusion: Patients presenting with trauma to periclavicular region must be thoroughly examined for associated axillary artery injury and if diagnosed with same must undergo prompt surgical exploration and arterial repair. For good proximal control, it is advisable to go for both supraclavicular and infraclavicular incisions in case of injury to 1st part of axillary artery.